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I had a great experience at the sleep study with the ResMed S9. They used pressures 6-9. The doc wrote the prescription for 6-14. My machine would automatically go to 14. It was too much and air was exhausinsting through my mouth. I had the pressure changed to 6-9, which is now tolerable, but the pressure still automatically goes to 9. My AH1s are less than 1. So, I cannot figure out why it was going up to 14 previously, or why it automatically goes to 9.

I tested the machine by putting it on and not going to sleep. I stayed wide awake reading a book. I'm assuming that being wide awake, I wouldn't have any apneas, and the pressure would stay at 6. Nope. The pressure automatically goes to 9.

So, it isn't auto titrating, or automatically adjusting. I've checked that it's on the "Autoset" setting.

Hi Ellsworth,
WELCOME! to the forum.!
I'm not sure what is causing your problem but hang in there for more suggestions. Hopefully, you'll get your CPAP situation straightened out.
Much success to you as you continue your CPAP therapy.

Take the card out and try your "read a book while wearing it" experiment again. Two machines from the same place makes it sound as if there is something on the card that is wrong. Like they are setting the machine but the card has a command on it for something else.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

The machine doesn't only look at apnea. It also looks at "flow limitations" and may increase pressure even if it doesn't report apneas.

You may actually need higher pressure due to these flow limitations and what's called UARS. It may also be that your breathing pattern confuses the machine.

Auto pressure doesn't work for some people. Luckily, all the auto machines can be set to a fixed pressure or a narrow pressure range. Since you have a fully data capable machine, you can adjust the manual pressure or pressure range up and down and see the results and find the pressure that works best for you.

Get the free SleepyHead software here. Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.

The machine may be autotitrating but, like Archangle wrote, your breathing may show characteristics of Flow Limitation, causing the machine to raise the pressure.

If it is not too late, I suggest exchanging the machine for the new A10 AutoSet For Her model, so you can try the gentler AutoSet For Her therapy mode.

The A10 AutoSet For Her (unlike the S9 AutoSet For Her) has 3 therapy modes, fixed-pressure CPAP therapy mode, standard AutoSet therapy mode, and the new gentle AutoSet For Her therapy mode. The A10 AutoSet for Her has everything the standard A10 AutoSet has, plus more, so it is like three machines in one.

The AutoSet For Her therapy mode raises the pressure more gently. It also includes the added feature that the Minimum Pressure setting will auto-adjust if needed, to better maintain an adequate therapy pressure.

The A10 AutoSet For Her model is the only ResMed model which reports Respiration Effort-Related Arousal (RERA) events. (RERAs are arousals caused by respiratory effort but RERAs do not qualify as hypopneas and are not counted in the AHI because the reduction in breathing was not at least 50%, or the Oxygen desaturation during the RERA was not deep enough.)

Take care,
--- Vaughn

Added: Another good option may be to try switching to the Philips Respironics System One REMSTAR Auto With Heated Hose.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.

I'm leaning towards Paula theory, the machine does not ramp pressure to the maximum in a flash

or maybe the machine set in CPAP mode, you need confirm it in the clinical menu, also you can view the setting at the long version of the sleep report (that will confirm the setting too)

If I make a bet with myself guessing the pressure display on the screen before turn off the machine
(while lying awake in bed first thing in the morning)
I win most of the times, usually around the minimum

Useful Links

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.